The term ‘medical billing’ refers to the process of submitting medical claims to medical insurance companies so that doctors or other healthcare providers can receive payment for services rendered. Additionally, medical billing consists of performing follow up checking of medical billing claims in order to determine the status of approval by insurance companies as well as status of payment.
Over the years medical billing has moved from paper records to electronic record keeping. This innovation has lowered the costs involved in processing medical claims and has also improved client care, Imedical Healthcare Solutions as medical history and physician recommendations and treatment plans can be stored in a central location that may be accessed across an entire network. This type of fully integrated electronic solution is more commonly referred to as electronic medical record or EMR.
Increasingly, healthcare providers are considering the advantages presented by outsourcing many of their medical billing, medical claims processing and medical coding processes. These services are being outsourced to less expensive workforces such as those in India and parts of Europe. Also, many medical billing workers work from home. Employers that outsource their medical billing work benefit in a number of ways. Medical billing and claims processing can require a large workforce of people to perform data entry and more advanced medical billing duties. By outsourcing, these healthcare providers don’t have to pay for office space to house this large workforce.
An electronic medical record, or EMR, is a computer-based patient medical record. An EMR allows access of patient data by healthcare staff at any given location within a network of computers. This also means that clinical staff members can input patient care data that will be instantly accessible by anyone else within the data network. These fully integrated types of data management systems allow healthcare providers to easily schedule treatments and care plans that do not conflict with data entered by other members of a patient’s team of healthcare providers. This also tremendously cuts down on the risk of medical mistakes that happen when paper records aren’t updated, or even when sloppy handwriting makes implementation of physician directions difficult.
Before electronic medical billing systems, medical billing and claims processing was done nearly exclusively on paper. With the advent of computers it has become possible to efficiently manage large amounts of claims using electronic medical billing software. Many medical billing software companies provide medical billing software to this particularly lucrative segment of the market.
The medical billing field has been challenged in recent years due to the introduction of the Health Insurance Portability and Accountability Act. Due to numerable restrictions put in place as a result of these new laws, many medical billing software companies and healthcare offices spent thousands, in some cases tens of thousands, of dollars on updated technology. Those affected by the HIPAA had to redesign and restructure their business processes and software to become compliant with this new act.
Over time there has also developed what is known as ‘straight through billing’. Straight through billing integrates the billing process within the practice management workflow, connecting patient scheduling, healthcare delivery, and medical records management. Every member of a practice’s management workflow receives an updated, unified and coherent picture of practice workload, patient and provider location, resource availability, and cash flow. Straight through billing requires integrated technologies for electronic medical records and straight through billing.